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Home My WebLink About5775-zExamined Approved TOWN CLERK'S OFFICE · SOUTHOLD, N. Y. ,19 ..... : Pem~t No. -'~ " ' ^pplicotJon No. Disapproved a/c ...................... ', .................................................................... .... ~/ ,<,, .....' ~.,'~.::.. '.~..: ......... (Building Inspector) APPLICATION FOR BUILDING~ERMIT INSTRUCTIONS Dote ....Ha~:cb..Z.~e .......................... , 19.7..2. ...... a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with ~,.- 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on' the promises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of~ buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws. ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signature ot applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or b~ilder. OWNER Name of owner of premises ............... I~:t,~..F..,~.J~II~. ..................................................................................................... If applicant is a corporate, signature of duly authorized officer· (Name and title of corporate officer) 1. Location of land on which proposed work will be done MapNo ~/~? t / · .: .................... Lo No .............................................. Street and bP~r~....,,...~....~_~c>~(~ .............................................. '"'"' ............................................................................. Num 1 Vtlla&~. Lane, Itattituck N Y Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... ~ ......... m,]r..~e ..................................................................................................... b. Intended use and occupancy ................ Lo=.L.--a ,mm~ez,.~hed ............................................................................. Nature of work (check which applicable): New Building ....... ~ ............. Addition ..................... Al'~q~tioll ............... Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... (Description) 4. Estimated Cost .......~1&O0, 00 .......................... Fee ............. ~tQ,0Q ........................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units .................Number of dwelling units on each floor ......................................... If garage, number ~f cars., ......................................................................................................................................... ~: .i '~ ': . 6. If business, comme-h:lal or m~xed occupancy, specify nature and extent of each type of use ..................................... 7., Din~n~l ef ~"~ting-~tJcet~res, if any: Front ..... LO..! ......... Rear 10!. ..................... Depth .....8.~. .......................... ~ ~rlekJfftf...,L~....~.~'.j~'e..%~..t .......................... Number of Stories ............................................................................. Dimensions of same structure with alterations or additions: Front .......................... Rear ......................................... Depth ..,¥)..._~.._...j.j.j..~._. ................. Hmght ......................................... Number of Stories ........................................ 8. Dimensions of entire new construction: Front ......................... Rear ............................ Depth ................................. Height Number of Stories ................. g. Size of lot: Front ......... , ............................ Rear .......................................... Depth .................................................. Height .................................................... Number of Stories ...................................................................................... 10. Date of Purchase ......... [.9..6..5. .................... Name of Former Owner .....~.......B...a~...t..e..:. ...................................................... 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... .bi..0.. .................................................. 13. Will lot be regreded .................................. Will excess fill be removed from premises: [ ] Yes [ ] No 14. Name of Owner of premises ................................... Naris ~. Ducey. ........ ~,....;l,~E,~l, ijgfl..~qp, fi&....l~R[..¥ ~RR.k. ......................................... . (Address) (Phone No.) Name of Architect ..................................................................................................................................................... (Address) (Phone No.) Name of Contractor ......................................................... (Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate wheth- erinterior or corner lot. Thlis is request ~or permit to place a small tool shed on the hack area of my property, The shed will be off the ground b mment blocks. It will house the lavnmover garden tools and hoses. These ~storage houses~ are for sale in dept. stores in Riverheazd~ or if I0 can do eo~ I will have someone build such a house but the cost rill not be over ~100o00 aa I cannot afford it. The propdrty all over measures approx 120~+ X 202~+/ T · rood shed__ __v°uld be placed on the rear &. described in pencil below, /~/~F__ -- ~l~-~/~'a' J~/~'~- ~ATEOFNEWYORK,~.~/ ~ ) ~ county o~ ................ ~.~.....~ . .................................... ~ .................................... ~. being duly sworn, depots and says that he is the appli~nt abo · ~ ~' ~"~ ............................................ ~ ............................. ~;~Y"~';;,";;""~"~;~'"""o~;~;7;',2~/ ..................................................................... of said owner or owners, and is duly authorized to ~rform or have ~rformed the said work and to make and file this application; that all s~temenU contained in this application are true to the best of his knowled~ and~el~ that the work will ~ ~Hormed in the ~nne~ =~t ~o., ,, ~,~ a~ph=a~,o. ~,~,~ ~,or~w,~,. ,~.'.~ ................. .~...~......~...~=v o~ ...... ~~ ................ ~ ..~,"~<~ /~ / / ~ ~ota~ ~ublic, ...,~.~ ......................... ~.7~.... ~u~* ~ ....................................................................................... ~ ................. 17-o. oo FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF: THE WORK AUTHORIZED) N? 5775 Z Permission is hereby granted to: ......... ~ ....... ~ ........ ~....~. ......... · ...~ ...... .~.~-..~ ........ ~ ...... .x~-,....~-.ff~..-.~...~;v .............................................. ot premise/Iocoted ot .................. ...~......,~.....~... ....... ..~..~..~. ........ ~~ .................................... .......... ~....'..../.. .............. ~.~ ......... ....~...~ ............... ~.~.,...~. ........................ pursuont tO applicotion doted .............................. ..~....~.......~., 19.?..~..L, ond opproved by the Building Inspector. Fee $..~.. .......... ~ ....... Building Inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined -~ ~ ~-~ 7 ~ ........................................ , 19 ........ Approved .................... ~.....~...../~.'.~:/'.~ 19....~...~-Pemit No. ~ ~ 7~- 2 __ Disapproved a/c ............... ~ .................................................................. .......... ...... ............. ............................ (Buildin~ ln~pector) Application No. -~' 776 ~- APPLICATION FOR BUILDING PERMIT Date ..... .~.~'.~-..~...~.-t .......................... , 197..2. ......... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffotl~ County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) ........ (' (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. OWNER Name of ow,er of premises ....... ~a~i~..~.,...O.%%~.~,y .............................................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.:............'~;~.,,...... LotNo .......... ( ................................... St reet a n d N u m bej~....Pg.?...¥..t..[,[.a~.e,. ,~,,a, ~,e..s.' .~..a..t..t. ~,t..u..c..k. ................................................................................................ w'~ O~ ~<~ --~ Municipality 2, State existing use and occupancy of premises and intended use and occupancy of proposed construction: a, Existing use and occupancy m home b, Intended use and occupancy ............ ~%,,and,,maw~=.,shed. ................................................................................ Nature of work (check which applicable): New Building ......... x ............ Addition ..................... Alteration ............... Repair ............. ............ Removal Demolition ........................ Other Work .................................... ......................... (Description) 4. Estimated Cost ..... ~.113Q..1313 ............................ Fee .....$.L0...09. ................................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units .................Number of dwelling units on each floor ......................................... If garage, number of cars ............................................................................................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................................... 7. Dimensions of existing structures, if any: Front .....................Rear ........................... Depth ................................... Height ........................................................... Number of Stories ............................................................................. Dimensions of same structure with alterations or additions: Front .......................... Rear ......................................... Depth............................... . ............. Height ......................................... Number of Stories ........................................ 8. Dimensions of entire new construction: Front [.Q. .................. Rear ...1,{~ ..................... Depth Height .....7.! ......................................... Number of Stories .....~ ................................................................................... 9. Size of lot: Front ...................................... Rear .......................................... Depth .................................................. Height .................................................... Number of Stories ...... 10. Date of Purchase ....,t9/~5 ......................... Name of Former Owner ....... I~,..3a~ta~ ................................................... 11. Zone or use district in which premises are situated ................ ~es .............................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ......... ~lll ............................................... 13. Will lot be regraded ....... ~ ......................... Will excess fill be removed from premises: [ ] Yes [ ] No 14. Name of Owner of premises ..... l~.v.i.~..~..llu~-y .......... .t...V.LLta~e..L_~_%..t{a~.~.i~-ck..[M~SZ ............................. Address) (Phone No.) Name of Architect ..................................................................................................................................................... (Address) (Phone No.) Name of Contractor ........... ~,;~..~ ............................................................................................................................. (Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from properW lines. Give street and block number or description according to deed, and show street names and indicate wheth- er interior or corner lot. This is request for pe~att to place a sa11 tool shed on the back. area of my property. The shed will be off the ground by cement blocks, It will house the lawamower garden tools and hoses. These %torage houses~ are for sale in dept. stores [~ Riverlle&{[; ~r if I can do s_o_. I, ~i11 haveamaeene build such a house but the cost will not over ~tuu. OO; asUI cannot aI£t)ra zn. ' The property all over measures approx 120~+ X 202~+o The tool shed would be placed on the rear~ as described in pencil below, I~ ~8.r~ VJ~sT ~/~ STATE OF NEW YORK, ' ~-'"'~,. ~ ,~ ,~ ._ ) c<, cou. Y o. .......................... ........... [N'a'me of individual signit~g ~;'~'t';'a'~[) .................... duly sworn, deposes and says that he is the applicant above named. He is the .............................................................................................................................................................................. (Contractor, agent, corporate officer, etc.} of sa d owner or owners, and is duly authorized to perform or have performed the said work.~nd to make and file this application; that all statements contained in this application are true to the best of his knowledge and b,e~f; .~.~at the work will be performed in the manner set forth in the application flied tharew)th. ~"~?<~17" ~ / ~ ~ ~.~,,~ ~k,:" ................ <...~ ................ day o~ .....................~ .............. ; ............ ,~ ......... ~, ~x,~ -. ' ,,~ _ ~ ...... _ ...... · .......... (si a,